AutoCRAT will develop novel sustainable cell and cell-derived therapies for osteoarthritis (OA). Osteoarthritis, a major disease, results in degradation of cartilage. It is the most common chronic joint condition, currently affecting >40 million Europeans. As no effective treatments for OA are available, it imposes a huge burden on the individual patient and European health care systems. Adult mesenchymal stem/stromal cells (MSCs) show early, promising clinical treatment efficacy in OA. However, costs of MSC production prevents widespread use for patients. Using human induced pluripotent stem cells (hiPSC), AutoCRAT will generate articular chondrocytes (hiCHOs) for cartilage repair to prevent development of OA and hiMSCs to treat established disease as sustainable therapeutic cell sources for therapies. Discovery of the osteoarthritis-specific hiMSC secretome will enable further refinement of these next-generation therapies; this will be achieved by molecular analysis of: 1) hiMSCs treated with synovial fluid from OA patients 2) EVs derived from these therapeutically-activated cells to develop the therapeutic osteoarthritis secretome. To ensure sustainable supply of high quality, affordable products, AutoCRAT will also develop a manufacturing pipeline composed of automated, regulatory-compliant robotic systems for production of the developed hiCHOs and hiMSCs and cell-secreted extracellular vesicle (EVs). The manufacturing pipeline can be extended to many other major diseases. The AutoCRAT consortium is composed of leading European scientific teams in stem cell biology, OA, preclinical efficacy and safety demonstration, GMP- and GAMP-compliant manufacturing of MSCs, regulatory affairs and health economics analysis. All aspects of AutoCRAT discovery and translation innovations will be guided by the imperative to deliver economically viable and regulatory-compliant therapies to OA-patients, the European health care system at large, and benefits to the European economy.